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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1981 and 1987, 53 of 102 patients with malignant diseases of the oesophagus underwent bypass surgery with gastric, colonic or jejunic interposition. To recognise the early or later complications, we used X-ray examination of the chest, water soluble contrast medium and barium meal, real-time sonography and CT. With these methods we found insufficiencies of anastomosis, stenosis, fistulae to the adjacent organs, necrosis, infections, erosions and ulcerations of the anastomosis, pleuropulmonary complications and metastases. Without of early complications were 30%, without of late complications only 8% of all patients.
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PMID:[Peri- and postoperative roentgen diagnosis following esophageal bypass operation]. 237 33

Between October 1980 and December 1985, 50 patients with esophageal cancer were treated with combined radiotherapy and chemotherapy (5-fluorouracil [5-FU] and mitomycin C). Thirty patients with stage I or II disease received definitive treatment consisting of 6,000 cGy in 6 to 7 weeks and 5-FU (1,000 mg/m2/24 h) as a continuous intravenous (IV) infusion for 96 hours, starting on days 2 and 29. Mitomycin C (10 mg/m2) was administered as a bolus injection on day 2. Twenty patients received palliative treatment (5,000 cGy plus chemotherapy) for stage III or IV disease (extraesophageal spread or distant metastases). All patients treated in this program had an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2. Of the 30 definitively treated patients, 23 had squamous cell cancer, while seven had adenocarcinoma. Follow-up ranged from 6 months to 63 months. The complete response rate at 1 to 3 months following completion of treatment was 87% (26 of 30) documented by barium swallow and endoscopy (+/- biopsy). The actuarially determined local relapse-free rate at 1 year and beyond was 73%, and the actuarial survivals at 1, 2, and 5 years were 68%, 47%, and 32%, respectively. Of the 20 palliatively treated patients, ten had squamous cell carcinoma, eight had adenocarcinoma, and two had undifferentiated carcinoma. Seventeen patients were evaluable for freedom from dysphagia 1 or more months following completion of treatment. Eighty-two percent of evaluable patients (14 of 17) had no dysphagia posttreatment, while 64% (11 of 17) remained free of dysphagia until death or last follow-up, emphasizing the significant local control of those patients. The median survival for this group was 8 months. Treatment was well tolerated, and acute toxicity included esophagitis, stomatitis, oral candidiasis, and hematologic toxicities of thrombocytopenia and neutropenia. Late toxicities were predominantly manifested as a mild to moderate benign stricture, which required dilatation in four patients. One patient developed a perforation into the mediastinum in the absence of tumor, while two patients with persistent local disease developed tracheoesophageal fistula, and radiation pneumonitis was observed in two patients. This combination of radiation therapy with infusional 5-FU and mitomycin C is an effective and relatively well-tolerated regimen in the treatment of esophageal cancer. Surgical resection may not be necessary when high-dose radiation and chemotherapy are used.
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PMID:Nonsurgical management of esophageal cancer: report of a study of combined radiotherapy and chemotherapy. 244 31

The authors report the case of a patient who developed a Streptococcus Bovis septicemia in the post-operative course of a surgical cure of an incarcerated umbilical hernia. There were no other complaints. A barium enema showed a malignant tumor of the descending colon. There were hepatic metastases. No complementary treatment was undertaken. The patient died shortly after. In the literature colonic proliferative lesions in association with this germ is reported in a total of 36% of proliferative lesions (15% of cancers and 21% of adenomas). It is concluded that the discovery of a malignant or premalignant proliferative lesion in one third of the cases justifies the exploration of the colon by barium enema and/or colonoscopy in the case of Streptococcus Bovis septicemia. The discovery of other digestive lesions (malignant or not) seems to be coincidental.
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PMID:[Streptococcus bovis septicemia and colonic cancer]. 249 13

Cancer of the colon and rectum appear to be epidemic in the US, with 150,000 cases expected during 1988. Two thirds of these patients are over age 60, and two thirds also have either full penetration of the bowel wall or metastases to regional lymph nodes. Mass screening via tests for occult blood in the stool is invaluable for detecting early carcinomas of the colon and rectum. Digital examination, endoscopy, and barium contrast radiographs help to confirm the diagnosis. Tumors of the colon and rectum are best treated operatively with appropriate lymphadenectomy and adequate margins, both proximally and distally, to guard against local recurrence. Certain factors, such as mucinous tumors, microinvasion, and non-exophytic tumors of the rectum have been shown to have a propensity for local recurrence. Local treatment by fulguration or electrocoagulation is advocated only for tiny tumors confined to a polyp, or for the extremely elderly or poor-risk patient. Radiation therapy appears to be an appropriate adjuvant to the treatment of rectal cancer either preoperatively or postoperatively.
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PMID:Colon cancer: diagnosis and prognosis in the elderly. 265 Dec 15

Colorectal cancer is more common in the Western world than in underdeveloped countries. Diet, longevity, heredity, and presence of other bowel diseases may affect the incidence. Diagnosis is based on results of routine laboratory studies and evaluation of the entire large bowel with air-contrast barium enema and colonoscopy. Surgical resection is the primary therapy for colorectal cancer. Postoperative systemic chemotherapy yields poor results, but hepatic artery infusional chemotherapy offers some benefit to patients who have only hepatic metastases. Follow-up evaluation includes physical examination and laboratory studies every 3 months for the first 2 years and colonoscopy every year.
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PMID:Update on colorectal cancer. Risk factors, diagnosis, and treatment. 267 71

We have retrospectively reviewed the radiographic and clinical features of 56 cases of pelvic rhabdomyosarcoma seen in three Pediatric Hospitals between 1960 and 1986. There were 35 boys and 21 girls. The study aimed at better defining the role played by the various imaging techniques in the investigation of these tumors. The role of diagnostic radiology is the detection and delineation of the primary tumor, its local spread and distant metastases at the time of diagnosis and on follow-ups. Intravenous urography (IVU) and to a lesser extent barium enema (BE) and cystography (VCUG) were used even after the availability of ultrasonography (US) and computed tomography (CT). These two modalities have only partly replaced the traditional radiographic techniques. All patients seen or followed after 1977 (28 patients) had both US and CT examinations. We have focused our discussion on these relatively new imaging modalities namely US and CT. Magnetic resonance was not utilized in any patient in this series. US was by far the best imaging technique available for lesions of the urinary bladder and those invading the bladder wall in children as it was possible to visualize, measure and follow these tumors. Scrotal US was used to confirm the clinical diagnosis of a paratesticular mass. CT showed to best advantage the tumour and its relationship to pelvic organs, musculature and bones.
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PMID:CT and ultrasound imaging of pelvic rhabdomyosarcoma in children. A review of 56 patients. 267 47

The radiological diagnosis and interventional management of neuroendocrine tumours of the gastrointestinal tract and pancreas are challenging, demanding the complete gamut of available resources. Carcinoid tumours are most commonly found in the appendix and small bowel. Barium studies usually disclose a small solitary mucosal or submucosal mass in the distal ileum at times associated with smooth muscle hypertrophy and thickening of the mucosal folds. Intussusception and bowel obstruction may be the presenting finding. Mesenteric involvement may evoke a desmoplastic reaction with rigidity, fixation, angulation and tethering of small bowel loops. Angiography may demonstrate a hypervascular primary neoplasm but more frequently reveals vascular encasement and distortion from the mesenteric desmoplastic reaction. Pancreatic islet cell tumour is best defined radiologically by angiography and computed tomography as a well circumscribed hypervascular mass which enhances with contrast material. Portal venous sampling is of considerable assistance in localizing insulinoma. Metastases from neuroendocrine tumours to lymph nodes and to the liver are usually hypervascular. In the evaluation of the liver by CT scanning prior to contrast as well as dynamic scanning during the bolus intravenous injection of contrast material are necessary. At times the precontrast scan is more revealing. Computed tomography with the catheter in the superior mesenteric artery followed by selective hepatic arteriography is the most accurate combination for the detection of hepatic metastases. Interventional radiological management by sequential hepatic arterial embolization is the treatment of choice for multiple hepatic metastases from neuroendocrine tumours. Thus far, the maximum number of embolic episodes in a single patient has been 13. The carcinoid syndrome has been controlled in 87% while 79% of islet cell tumour hepatic metastases have responded. Contraindications to HAE includes a combination of all of the following: (i) replacement of more than 50% of the liver by tumour, (ii) serum lactic dehydrogenase above 425 mU/ml, (iii) serum glutamic oxaloacetic transaminase above 100 mU/ml, and (iv) bilirubin above 2 mg/dl. In the face of occlusion of the portal vein by intravascular neoplasm, HAE is contraindicated only if portal flow through collateral vein is away from the liver.
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PMID:Gastrointestinal and pancreatic endocrine tumours. 267 21

A 66-year-old man with a primary gastric choriocarcinoma is presented. The pre-operative diagnosis of the gastric barium examination and an endoscopy was an unusual gastric carcinoma in the antrum. At laparotomy, an abscess in the lesser sac that had developed by a tumoral penetrance was found. Thus a total gastrectomy and a lymphadenectomy with a reconstruction was performed. The resected specimen was found to be a Borrmann 1 type tumor, and a histological examination showed it to be a choriocarcinoma with a syncytiotrophoblast, that was immunostained by human chorionic gonadotropin (HCG). The physical findings however, disclosed no tumor in the testis. The serum HCG was found to be 1,380 IU/l on the 7th postoperative day, then a pulmonary metastases appeared and progressed, and the patient died on the 22nd postoperative day.
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PMID:[A case of primary gastric choriocarcinoma]. 268 80

In 1978, a prospective program was initiated to evaluate postoperative monitoring of patients after resection of carcinoma of the colon and rectum. The program included clinical examination, interval endoscopy, measurement of carcinoembryonic antigen (CEA), selected liver function tests (alkaline phosphatase and gamma glutamyl transferase) and roentgenologic testing: roentgenograms of the chest, barium enema, intravenous pyelogram (IVP) and computerized axial tomographic (CAT) scan. Of the initial 226 patients enrolled, 179 had at least one abnormal elevation of the CEA level, and in 70 (39 per cent), recurrence developed. Of the 70 with recurrence, 62 (89 per cent) had elevated CEA levels (greater than 3.0 nanograms per milliliter) prior to detection of recurrence by other means. Eight patients had normal levels (two were false-negative and the other six were tested at inappropriate times). Although other test results often complemented CEA, they were generally less sensitive for early detection. Selective use of these tests frequently documented site and extent of recurrence. The detection sensitivity of these other tests was highest with CAT scan (83 per cent), followed by barium enema and endoscopy (56 and 46 per cent). Forty-five patients underwent re-exploration. Recurrence was found in 42, of whom 23 had resectable disease (five of 11, liver; 17 of 24, local or pelvis, and one of one, lung). In three patients, nothing abnormal was found at exploration; two of these patients ultimately had metastases develop. The median survival time was 43 months and the estimated five year survival rate was 38 per cent. CEA is the best over-all indicator of early recurrence and frequent testing at short intervals is most important. Periodic clinical examination and selected other studies are also essential for early documentation of recurrence. Second-look surgical procedures appear beneficial for survival time in selected patients.
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PMID:Prospective monitoring trial for carcinoma of colon and rectum after surgical resection. 268 53

Computed tomography (CT) was useful to evaluate the rectal cancer about not only the diagnosis of extracanal invasion to other organs and/or the pelvic wall, but also the diagnosis of its recurrence and pelvic lymph nodes metastases. Cancerous lesions were easily recognized as the localized thickness of the rectal wall when air was injected into the rectal lumen. But the screening and the differential diagnosis of rectal abnormalities with CT were limited, because rectal mucosal pattern can not be imaged in detail. So, CT should be carried out after the differential diagnosis and the location of rectal abnormalites can be obtained by the barium enema or the endoscopy.
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PMID:[Usefulness and limitation of computed tomography in the diagnosis of rectal cancer]. 274 54


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